Hedström Jonas, Andersson Bodil
Department of Clinical Sciences Lund, Surgery, Lund University and Skåne University Hospital, Lund, Sweden.
Heliyon. 2022 Oct 26;8(11):e11184. doi: 10.1016/j.heliyon.2022.e11184. eCollection 2022 Nov.
Gallstones intervention during pregnancy might be a stressful event for both mother and fetus and stress might affect outcome. The aim of this study was to identify factors that might improve the care of pregnant patients in need of intervention for gallstone disease.
By crossmatching the Swedish Registry of Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) and the Swedish Medical Birth Registry, we identified patients with gallstone intervention during pregnancy. A questionnaire covering patient experience before, during and after surgery and the Beck Depression Inventory II (BDI-II) were distributed.
In total, 275 patients subjected to cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) or both were identified, and 146 (54%) patients responded. Surgery was in median performed in pregnancy week 16 (12-20), and 62 (42%) patients had symptoms of gallstone disease before pregnancy, with 17 of these patients scheduled for surgery before pregnancy. Thirty-four (24%) patients felt that the information regarding the upcoming surgery was inadequate, with differences comparing patients with overall favorable versus overall non-favorable experiences (103 (89%) vs. 8 (27%) p < 0.001) and similar differences regarding information on disease/symptoms (95 (84%) vs. 12 (43%), p < 0.001). A majority (57%) were very worried about their expected child, and 51% thought that no measures were taken to relieve their worries. Recurring as suggested improvements was more information about the disease and the surgical procedure.
Intervention due to gallstone disease during pregnancy is a stressful event that impacts many patients negatively, both before and after surgery. Patient education might positively affect patient experience.
孕期胆结石干预对母亲和胎儿来说可能都是一件压力很大的事情，而压力可能会影响结果。本研究的目的是确定可能改善需要进行胆结石疾病干预的孕妇护理的因素。
通过对瑞典胆结石手术和内镜逆行胰胆管造影登记处（GallRiks）与瑞典医学出生登记处进行交叉匹配，我们确定了孕期进行胆结石干预的患者。发放了一份涵盖患者手术前、手术期间和手术后经历的问卷以及贝克抑郁量表第二版（BDI-II）。
总共确定了275例接受胆囊切除术、内镜逆行胰胆管造影（ERCP）或两者皆有的患者，146例（54%）患者做出了回应。手术中位时间为妊娠第16周（12 - 20周），62例（42%）患者在怀孕前有胆结石疾病症状，其中17例患者在怀孕前就计划进行手术。34例（24%）患者认为关于即将进行的手术的信息不足，在总体体验良好与总体体验不佳的患者之间存在差异（103例（89%）对8例（27%），p < 0.001），在疾病/症状信息方面也有类似差异（95例（84%）对12例（43%），p < 0.001）。大多数（57%）患者非常担心自己预期中的孩子，51%的患者认为没有采取措施缓解他们的担忧。反复被提及的建议改进措施是更多关于疾病和手术过程的信息。
孕期因胆结石疾病进行干预是一个压力很大的事件，对许多患者在手术前后都产生了负面影响。患者教育可能会对患者体验产生积极影响。
